Authors
Carlos Ulloa Luchsinger, Sebastián Tapia Corón, Hernán Ramírez Skinner
Published in
Cureus. Volume 18. Issue 7. Pages e112649. Epub Jul 14, 2026.
Abstract
Cervicofacial emphysema is defined as the pathological presence of air within the fascial spaces of the neck and face. Dental procedures are a recognized but uncommon cause, and only rarely do they involve the mediastinum; such cases are typically related to the use of high-speed air-driven handpieces or air/water (triple) syringes, producing pneumomediastinum. We report a 22-year-old woman who presented to the emergency department with sudden-onset dyspnea immediately after the extraction of two right-sided third molars performed with high-speed air-driven rotary instruments. Contrast-enhanced computed tomography confirmed cervical subcutaneous emphysema and pneumomediastinum. She was admitted for airway and hemodynamic monitoring; an esophagogram excluded esophageal injury, prophylactic antibiotics were administered, and she recovered uneventfully, being discharged on the third day. At one-week follow-up, the patient reported complete resolution of dyspnea and chest pain, with no residual cervical swelling or crepitus. Although air-driven handpieces and air syringes are safe and essential tools in dental practice, their use during invasive procedures and in anatomically high-risk areas warrants caution, as it may rarely result in this potentially life-threatening complication. Early recognition and a conservative, multidisciplinary approach are key to a favorable outcome.
PMID:
42598580
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.
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